Are We Doing Enough to Prevent Another Scott County? Probably Not

4 years ago, few people outside of the roughly 24,000 folks
who lived there had ever heard of Scott County, Indiana. Unfortunately, today,
thanks to an injection drug use-fueled HIV outbreak there which resulted in 200
people contracting the virus, Scott County is now shorthand for the type of syndemic
opioid-related disaster that HIV advocates and public health experts are
worried will happen again. Fortunately, an outbreak as explosive as the one in Scott County has yet to occur, but in the intervening years, trends in injection drug use and new HIV diagnoses in the United States provide no solace.

All across the country, reports are coming in from federal,
state and local health officials that show HIV and Hepatitis C infections among
people who inject drugs rising in tandem with the broader patterns in the
opioid epidemic. In Massachusetts, the state's health department recently
released a study showing that an outbreak of HIV among people who inject drugs
in and around the city of Lowell was larger than previously thought, with 129
new cases of HIV identified in that population since 2015. In Montana,
state Department of Health officials are reporting that the percentage of new
HIV cases that have occurred among people who inject drugs in the first half of
2018 has more
than doubled from the previous year. And, in Cincinnati and Northern
Kentucky—an area that has become one of the epicenters of the opioid epidemic in
America—HIV
diagnoses among people who inject drugs in 2017 were respectively 3 and 4 times
higher than the previous year.

These are all laudable efforts, but if we are to stand a chance
of both stemming the tide of the opioid crisis and stopping injection drug
use-related HIV transmission, so much more must be done. AIDS United both
supports the efforts of these state and local health departments and at the
federal level endorses
Senator Elizabeth Warren and Representative Elijah Cummings’ Comprehensive
Addiction Resources Emergency (CARE) Act of 2018, which would authorize
significant, long-term funding for local strategies that reduce fatal
overdoses, increase substance use treatment, and address the infectious disease
consequences of the opioid crisis, and encourages Congress to sustain the
current federally supported Medicaid Program.